4.4 Article

Home, school, and community violence exposure and emotional and conduct problems among low-income adolescents: the moderating role of age and sex

Journal

SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY
Volume 57, Issue 1, Pages 95-110

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00127-021-02143-4

Keywords

Adolescence; Exposure to violence; Mental health; Effect modifier; epidemiologic

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This study found an association between violence exposure and emotional/conduct problems, with age and sex moderating this relationship. Community violence victimization was associated with emotional problems in girls, while severe physical punishment was linked to conduct problems in younger individuals.
Purpose The purpose of this study is to assess whether violence exposure is associated with emotional/conduct problems, when adjusting for confounders/covariates and controlling for comorbidity, and to investigate interactions between violence exposure and sex and/or age. Methods This cross-sectional study evaluated a community-based sample of 669 in-school 11-15-year-olds. A three-stage probabilistic sampling plan included a random selection of census units, eligible households, and target child. Multivariable logistic regression investigated the effect of severe physical punishment by parents, peer victimization at school, and community violence on the study outcomes (adolescent-reported emotional/conduct problems identified by the Strengths and Difficulties Questionnaire/SDQ) when controlling for confounders (resilience, parental emotional warmth, maternal education/unemployment/anxiety/depression) and covariates (age, sex, stressful life events, parental rejection). Results Considering interactions, emotional problems were associated with community violence victimization among girls, while conduct problems were associated with severe physical punishment among the younger, suffering peer aggression among the oldest, bullying victimization among girls, and witnessing community violence among boys. Desensitization (less emotional problems with greater violence exposure) was noted among the youngest exposed to severe physical punishment and the oldest who witnessed community violence. Conclusion Age and sex are moderators of the association between violence exposure and emotional/conduct problems. Interventions at local health units, schools, and communities could reduce the use of harsh physical punishment as a parental educational method, help adolescents deal with peer aggression at school and keep them out of the streets by increasing the usual five hours in school per day and making free sports and cultural/leisure activities available near their homes.

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